Recent work has identified a transcription factor, nuclear factor KAPPA B (NF-KB) which induces the TNF-α encoding gene and activates the cyclooxygenase-2 (COX-2) pathway. At 24 hours post irradiation HIF-1a and COX-2 protein levels were increased. In addition to its well established DNA-damage effects, ionizing radiation induces cell death, and radiation-induced activation of acid sphingomyelinases (ASMases) and the generation of ceramide. Ceramide is generated from sphingomyeline by the action of a neutral or ASMase or by de novo synthesis coordinated through the enzyme ceramidesynthase. Once generated, ceramide may serve as a second messenger molecule in signaling responses to physiologic or environmental stimuli, or it may be converted to a variety of structural or effector molecules. With a single dose of 3 Gy, there is activation of protein kinase B/AKT (PKB/AKT) signaling. Within minutes of irradiation, phosphorylation of the serine/threonin protein kinase PKB/AKT at serine-residue 473 appears. This activation of PKB/AKT contributes to inhibit glycogen synthase kinase-3beta (GSK3beta), which has a clear inhibitory role in endothelial cell survival.
One problem first responders face in the event of a nuclear disaster is to rapidly and efficiently identify victims that need medical treatment and determine what level of treatment is appropriate. It is a priority to minimize time to diagnosis to identify patient treatment needs, minimize the time required for emergency technicians (ET) provide diagnosis, minimize the number of interactions with the patient, minimize system stockpile cost, minimize the dependence on infrastructure (communications, transport, etc.), minimize the needs for trained personnel to administer tests, and uniquely identify patient and diagnostic results.
Simple, quick test strips that change color, like the ones used for sugar or albumin by diabetics, are currently available. They are used without medical or other highly trained personal or expensive equipment. It would be highly desirable to provide such a simple test strip that changes color that could be used as evidence of ionizing radiation (IR) exposure. A positive test that could be used to identify a person who has been exposed to radioactive material has many applications.